Lacrisert 5mg Opthalmic Insert 60s
It is used to treat dry eyes.It is used to treat eye irritation.
Drug Class
Ophthalmic Lubricant
Pharmacologic Class
Cellulose Derivative; Artificial Tear
Pregnancy Category
Not assigned (minimal systemic absorption)
FDA Approved
Mar 1981
DEA Schedule
Not Controlled
Overview
What is this medicine?
Lacrisert is a small, rice-grain sized insert that you place in your eye once a day. It slowly dissolves and releases a lubricating substance that helps keep your eyes moist and comfortable, relieving symptoms of dry eye.
How to Use This Medicine
Proper Use of This Medication
To use this medication correctly, follow your doctor's instructions and read all the information provided. For ophthalmic use only. Before using, wash your hands thoroughly. Do not remove the medication from the blister pack until you are ready to use it, and do not store the removed medication for future use. Use the applicator to administer the medication as directed. After use, clean the applicator and store it according to the instructions provided.
Storage and Disposal
Store this medication at room temperature in a dry place, avoiding storage in a bathroom. Keep the medication in its original blister pack. Store all medications in a safe location, out of the reach of children and pets. Dispose of unused or expired medications properly. Do not flush them down the toilet or pour them down the drain unless instructed to do so. If you have questions about disposal, consult your pharmacist. You may also want to check if there are drug take-back programs available in your area.
Missed Dose Instructions
If you use this medication on a regular schedule, take the missed dose as soon as you remember. However, if it is close to the time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not take two doses at the same time or extra doses. If you use this medication as needed, do not use it more frequently than directed by your doctor.
To use this medication correctly, follow your doctor's instructions and read all the information provided. For ophthalmic use only. Before using, wash your hands thoroughly. Do not remove the medication from the blister pack until you are ready to use it, and do not store the removed medication for future use. Use the applicator to administer the medication as directed. After use, clean the applicator and store it according to the instructions provided.
Storage and Disposal
Store this medication at room temperature in a dry place, avoiding storage in a bathroom. Keep the medication in its original blister pack. Store all medications in a safe location, out of the reach of children and pets. Dispose of unused or expired medications properly. Do not flush them down the toilet or pour them down the drain unless instructed to do so. If you have questions about disposal, consult your pharmacist. You may also want to check if there are drug take-back programs available in your area.
Missed Dose Instructions
If you use this medication on a regular schedule, take the missed dose as soon as you remember. However, if it is close to the time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not take two doses at the same time or extra doses. If you use this medication as needed, do not use it more frequently than directed by your doctor.
Lifestyle & Tips
- Wash hands thoroughly before handling the insert.
- Do not touch the insert with your fingers directly; use the supplied applicator or clean, dry tweezers.
- Insert into the lower eyelid pocket (inferior cul-de-sac) once daily, preferably in the morning.
- If you wear contact lenses, remove them before inserting Lacrisert. You may reinsert them after 15 minutes.
- Avoid rubbing your eyes vigorously after insertion.
- Store inserts in their original foil pouches at room temperature, protected from moisture.
- If using other eye drops, wait at least 15 minutes after inserting Lacrisert before applying other drops.
Available Forms & Alternatives
Available Strengths:
Dosing & Administration
Adult Dosing
Standard Dose:
One 5 mg ophthalmic insert once daily, inserted into the inferior cul-de-sac of the eye.
Dose Range:
5 - 5 mg
Condition-Specific Dosing:
severeDryEye:
May be used twice daily (morning and evening) if symptoms are severe.
Pediatric Dosing
Neonatal:
Not established
Infant:
Not established
Child:
Not established (safety and efficacy not specifically studied, but generally considered safe for older children if clinically indicated due to minimal systemic absorption)
Adolescent:
One 5 mg ophthalmic insert once daily, similar to adult dosing, if clinically indicated.
Dose Adjustments
Renal Impairment:
Mild:
No adjustment needed
Moderate:
No adjustment needed
Severe:
No adjustment needed
Dialysis:
No adjustment needed (minimal systemic absorption)
Hepatic Impairment:
Mild:
No adjustment needed
Moderate:
No adjustment needed
Severe:
No adjustment needed
Pharmacology
Mechanism of Action
Hydroxypropyl Cellulose is a water-soluble, inert, ophthalmic insert that acts as an artificial tear. When placed in the inferior cul-de-sac of the eye, it absorbs moisture from the tear film and swells, forming a hydrophilic film that stabilizes and thickens the precorneal tear film and prolongs the tear breakup time. It also lubricates the ocular surface, reducing symptoms of dry eye.
Pharmacokinetics
Absorption:
Bioavailability:
Minimal to none (systemic)
Tmax:
Not applicable (local action)
FoodEffect:
Not applicable
Distribution:
Vd:
Not applicable (local action)
ProteinBinding:
Not applicable (local action)
CnssPenetration:
No
Elimination:
HalfLife:
Not applicable (local action, dissolves over time)
Clearance:
Not applicable (local action)
ExcretionRoute:
Not applicable (dissolves and is cleared with tears)
Unchanged:
Not applicable
Pharmacodynamics
OnsetOfAction:
Within minutes (as insert begins to hydrate and dissolve)
PeakEffect:
Sustained release over several hours
DurationOfAction:
Up to 24 hours (insert dissolves completely within 14-18 hours, providing continuous lubrication)
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
While rare, some people may experience severe and potentially life-threatening side effects when taking this medication. Immediately contact your doctor or seek medical attention if you experience any of the following symptoms, which may indicate a serious reaction:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Eye or eyelid swelling
Changes in eyesight, eye pain, or severe eye irritation
Other Possible Side Effects
Like all medications, this drug can cause side effects. Although many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. Contact your doctor or seek medical help if you experience any of the following side effects or if they persist or bother you:
Blurred eyesight
* Short-term pain after use
Note: This is not an exhaustive list of potential side effects. If you have questions or concerns about side effects, consult your doctor. For medical advice about side effects, you can also contact your doctor. Additionally, you can report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
While rare, some people may experience severe and potentially life-threatening side effects when taking this medication. Immediately contact your doctor or seek medical attention if you experience any of the following symptoms, which may indicate a serious reaction:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Eye or eyelid swelling
Changes in eyesight, eye pain, or severe eye irritation
Other Possible Side Effects
Like all medications, this drug can cause side effects. Although many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. Contact your doctor or seek medical help if you experience any of the following side effects or if they persist or bother you:
Blurred eyesight
* Short-term pain after use
Note: This is not an exhaustive list of potential side effects. If you have questions or concerns about side effects, consult your doctor. For medical advice about side effects, you can also contact your doctor. Additionally, you can report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Seek Immediate Medical Attention If You Experience:
- Persistent or worsening eye irritation or discomfort
- Excessive tearing or discharge
- Changes in vision (other than transient blurring upon insertion)
- Eye pain or redness
- Signs of eye infection
Before Using This Medicine
Before Taking This Medication: Important Information to Share with Your Doctor
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the symptoms you experienced as a result of the allergy.
All medications you are currently taking, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins. This information will help your doctor assess potential interactions between this medication and other substances.
* Any existing health problems, as they may affect the safety and efficacy of this medication.
To ensure your safety, it is crucial to verify that this medication can be taken with all your current medications and health conditions. Never start, stop, or adjust the dose of any medication without first consulting your doctor.
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the symptoms you experienced as a result of the allergy.
All medications you are currently taking, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins. This information will help your doctor assess potential interactions between this medication and other substances.
* Any existing health problems, as they may affect the safety and efficacy of this medication.
To ensure your safety, it is crucial to verify that this medication can be taken with all your current medications and health conditions. Never start, stop, or adjust the dose of any medication without first consulting your doctor.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. When taking this drug, exercise caution when driving or performing tasks that require clear vision, as it may affect your eyesight. You may find that bright lights are bothersome; wearing sunglasses can help alleviate this discomfort. To avoid irritating your eye, refrain from rubbing the treated area. Note that this medication is not intended to treat irritation caused by contact lenses. If you are pregnant, planning to become pregnant, or are breastfeeding, consult your doctor to discuss the potential benefits and risks of using this medication, both for you and your baby.
Overdose Information
Overdose Symptoms:
- Unlikely to occur with ophthalmic insert due to local action and small dose. May cause temporary blurring or foreign body sensation if multiple inserts are used.
What to Do:
Remove the insert(s) if possible. Rinse eye with sterile saline or artificial tears. If symptoms persist, contact a healthcare professional. For general overdose concerns, call 1-800-222-1222 (Poison Control).
Drug Interactions
Monitoring
Baseline Monitoring
Ocular examination (e.g., slit lamp, tear film assessment)
Rationale: To assess severity of dry eye and rule out other conditions.
Timing: Prior to initiation of therapy
Routine Monitoring
Symptom relief (e.g., dryness, irritation, foreign body sensation)
Frequency: Daily, patient self-assessment
Target: Reduction or elimination of symptoms
Action Threshold: Persistent or worsening symptoms may require re-evaluation by ophthalmologist.
Ocular comfort and tolerability
Frequency: Daily, patient self-assessment
Target: Acceptable comfort level
Action Threshold: Significant discomfort, foreign body sensation, or irritation may require discontinuation or re-evaluation.
Symptom Monitoring
- Reduction in dry eye symptoms (e.g., burning, stinging, grittiness)
- Improved ocular comfort
- Clarity of vision (transient blurring may occur upon insertion)
- Absence of excessive tearing or discharge
Special Patient Groups
Pregnancy
Generally considered safe during pregnancy. Due to minimal to no systemic absorption, maternal and fetal exposure is negligible. Use only if clearly needed.
Trimester-Specific Risks:
First Trimester:
Minimal risk
Second Trimester:
Minimal risk
Third Trimester:
Minimal risk
Lactation
Generally considered safe during breastfeeding. Hydroxypropyl cellulose is not systemically absorbed, so it is highly unlikely to be excreted in breast milk or cause harm to a nursing infant.
Infant Risk:
Minimal risk (L1 - Lowest Risk)
Pediatric Use
Safety and efficacy have not been established in pediatric patients. However, due to minimal systemic absorption, it is generally considered safe for use in older children and adolescents under ophthalmologist supervision if clinically indicated for severe dry eye.
Geriatric Use
No specific dosage adjustment is required for geriatric patients. The safety and efficacy profile is similar to that in younger adults.
Clinical Information
Clinical Pearls
- Lacrisert is particularly useful for patients with chronic severe dry eye who do not get sufficient relief from conventional artificial tears or who have difficulty with frequent drop instillation.
- Proper insertion technique is crucial for patient comfort and efficacy. Patients should be thoroughly instructed and may need to practice.
- Transient blurring of vision immediately after insertion is common and usually resolves quickly as the insert hydrates.
- Some patients may experience a foreign body sensation initially, which typically diminishes as the insert softens and conforms to the eye.
- The insert is designed to dissolve completely over 14-18 hours, providing continuous lubrication without the need for repeated applications throughout the day.
- Patients should be advised to remove the insert if they experience significant irritation or discomfort that does not resolve.
Alternative Therapies
- Over-the-counter artificial tears (e.g., carboxymethylcellulose, hyaluronic acid, polyethylene glycol, propylene glycol)
- Prescription eye drops for dry eye (e.g., cyclosporine ophthalmic, lifitegrast ophthalmic)
- Punctal plugs
- Warm compresses and eyelid hygiene
- Omega-3 fatty acid supplements (adjunctive therapy)
Cost & Coverage
Average Cost:
Varies, typically $150-$300 per 60 inserts
Insurance Coverage:
Varies by insurance plan; may be covered as a Tier 2 or 3 prescription, or may require prior authorization. Some plans may prefer OTC artificial tears.
General Drug Facts
If your symptoms or health issues persist or worsen, it's essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so be sure to check with your pharmacist for more details. If you have any questions or concerns about your medication, don't hesitate to reach out to your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. When seeking help, be prepared to provide information about the medication taken, the amount, and the time it happened.